Evolving concepts on bradykinesia

Bologna, Matteo; Paparella, Giulia; Fasano, Alfonso; Hallett, Mark; Berardelli, Alfredo

doi:10.1093/brain/awz344

Cited by 165 publications

(194 citation statements)

References 362 publications

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“…Alternatively, slowed movement in VIT may directly reflect the detrimental effect of valproate on the cerebellar and basal ganglia function. In this regard, the cerebellum is known to contribute to the encoding of voluntary movement parameters, such as movement direction and velocity [16,21,22], and in line with this observation, patients with cerebellar lesions may be slow [23]. Similarly, movement slowness in VIT may be due to the involvement of basal ganglia [24,25], which are known to play an important role in controlling movement speed [21].…”

Section: Discussionmentioning

confidence: 82%

Clinical and Kinematic Features of Valproate-Induced Tremor and Differences with Essential Tremor

et al. 2020

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Tremor is a common movement disorder that can be induced by medications, including valproate, which is used for the treatment of epilepsy. However, the clinical and neurophysiological features of valproate-induced tremor are still under-investigated. We performed a clinical and kinematic assessment of valproate-induced tremor by considering tremor body distribution and activation conditions. We investigated possible correlations between demographic and clinical data and kinematic features. Valproate-induced tremor results were also compared with those collected in a large sample of patients with essential tremor. Sixteen valproate-induced tremor patients and 93 essential tremor patients were enrolled. All participants underwent a standardised neurological examination and video recording. Patients also underwent an objective assessment of postural, kinetic and rest tremor of the upper limbs and head tremor through kinematic analysis. Nonparametric tests were used for statistical comparisons between the two groups. Clinical evaluation showed a higher occurrence of rest tremor as well as head or voice, and lower limb involvement in patients with valproate-induced tremor. Kinematic analysis showed a substantial variability in the tremor features of patients with valproate-induced tremor. Compared to essential tremor, we found a higher occurrence of rest tremor of the upper limbs and the involvement of more body segments in valproate-induced tremor patients. Valproate-induced tremor has distinctive clinical and kinematic features, which may suggest that valproate interferes with the cerebellar functions.

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Section: Discussionmentioning

confidence: 82%

Clinical and Kinematic Features of Valproate-Induced Tremor and Differences with Essential Tremor

et al. 2020

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“…In ET, movement slowness has objectively been demonstrated by kinematic analysis of repetitive movements of the upper limb and fingers [9–14]. Importantly, none of these studies has assessed whether movement slowness in ET is associated with a sequence effect [15], which is a feature of bradykinesia in PD [1–3]. Finally, the relationship between movement abnormalities and tremor severity in ET also needs clarification.…”

Section: Introductionmentioning

confidence: 99%

Is there evidence of bradykinesia in essential tremor?

Bologna

Paparella

Colella

et al. 2020

Euro J of Neurology

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Background and purpose Essential tremor (ET) is a movement disorder primarily characterized by upper limb postural and kinetic tremor. Although still under‐investigated, bradykinesia may be part of the phenotypic spectrum of ET. The aim was to evaluate bradykinesia features in ET through clinical examination and kinematic analysis of repetitive finger movements. Data collected in ET patients were compared with those recorded in Parkinson’s disease patients and healthy controls. Methods Overall, 258 subjects participated in the study (90 ET patients, 84 Parkinson’s disease patients and 84 healthy controls). Repetitive finger tapping was kinematically recorded using a motion analysis system. Movement velocity, amplitude and decrement (sequence effect) were measured. The three groups were first compared by one‐way analysis of variance. A cluster analysis was also performed to better address the data variability observed in ET patients. Possible relationships between kinematic and clinical data were assessed in ET patients. Results Essential tremor patients were slower than healthy controls. Movement slowness in ET did not correlate with postural or kinetic tremor severity. It was also found that movement slowness in ET was not associated with a sequence effect, which instead is a common feature in Parkinson’s disease. Cluster analysis showed that a proportion of ET patients may have movement abnormalities similar to those observed in Parkinson’s disease. Conclusions Movement slowness without sequence effect is a common feature in ET patients. The present findings are relevant when interpreted in the context of the new tremor classification system and in the development of a more accurate bradykinesia definition.

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“…A cardinal motor symptom of many PD patients is bradykinesia, which might be best summarized as 'slowness of movement' [13,14]. The neuropsychological equivalent of bradykinesia in PD is bradyphrenia, i.e., 'slowness of thought' [15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Computational Modeling for Neuropsychological Assessment of Bradyphrenia in Parkinson’s Disease

Steinke

Lange

Seer

et al. 2020

JCM

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The neural mechanisms of cognitive dysfunctions in neurological diseases remain poorly understood. Here, we conjecture that this unsatisfying state-of-the-art is in part due to the non-specificity of the typical behavioral indicators for cognitive dysfunctions. Our study addresses the topic by advancing the assessment of cognitive dysfunctions through computational modeling. We investigate bradyphrenia in Parkinson’s disease (PD) as an exemplary case of cognitive dysfunctions in neurological diseases. Our computational model conceptualizes trial-by-trial behavioral data as resulting from parallel cognitive and sensorimotor reinforcement learning. We assessed PD patients ‘on’ and ‘off’ their dopaminergic medication and matched healthy control (HC) participants on a computerized version of the Wisconsin Card Sorting Test. PD patients showed increased retention of learned cognitive information and decreased retention of learned sensorimotor information from previous trials in comparison to HC participants. Systemic dopamine replacement therapy did not remedy these cognitive dysfunctions in PD patients but incurred non-desirable side effects such as decreasing cognitive learning from positive feedback. Our results reveal novel insights into facets of bradyphrenia that are indiscernible by observable behavioral indicators of cognitive dysfunctions. We discuss how computational modeling may contribute to the advancement of future research on brain–behavior relationships and neuropsychological assessment.

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Evolving concepts on bradykinesia

Cited by 165 publications

References 362 publications

Clinical and Kinematic Features of Valproate-Induced Tremor and Differences with Essential Tremor

Clinical and Kinematic Features of Valproate-Induced Tremor and Differences with Essential Tremor

Is there evidence of bradykinesia in essential tremor?

Computational Modeling for Neuropsychological Assessment of Bradyphrenia in Parkinson’s Disease

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